My FUE experience so far with Dr Feller

[NervousNelly]

Bill,

To lighten things up--I do like how your name gets altered from time to time---"Billros". Its kind of like Velcro, you know how it sticks to you and you just can't shake it. I'm sure this is how some of the docs feel when you step outside the box and bring up some great discussions and very valid points. "Damn that Velcro/Billro guy." Keep bringing on these topics as we all benefit immensely from your "unabashed" drive for educating and creating change and looking out for us little guys. Its very much appreciated. Can you tell I just figured out how to use the graemlins? If a computer idiot like myself can figure this out I'm sure that these docs can figure out how to post the type of photos and info we are demanding, especially when it potentially may increase their $$$.

[Bill - Seemiller]

Hello everyone, again.

 

Thanks for an interesting discussion. thanks to B Spot and others who have pointed out so correctly that my post is not to question the integrity and ethics of Dr. Feller or bring him down, etc.

 

Hairroot,

 

Perhaps you should re-read my post, especially my first and last sentence. I encourage you to bring your defenses down significantly, however, before you read.

 

Anyway...I understand you are taking this extra personal because you just had an amazing transformation with Dr. Feller, and you feel like you are being attacked because your doctor is being questioned. It's imperative as a forum member AND a human being that you learn to step outside of that mode. Try to be more objective and read the content for what it's worth. BUT, if it helps, allow me to try to reassure you that you do not need to defend someone who is not being attacked.

 

My posts are simply questions and my opinions that have nothing to do with his ethics. I have already stated, personally, that since I know this ahead of time, if I EVER considered FUE, I probably wouldn't go to him simply because I can't afford to be out $4000. I would only EVER consider FUE at this point anyway if I am indeed out of strips (funny how nobody still has refuted this point).

 

Anyway...what you said about FUE is indeed incorrect. Nobody is trying to tarnish FUE, however, even Dr. Feller himself has admitted that FUE is inferior to FUT regarding yields. I quote him from a previous post on this thread:

 

"But I can't afford to lose valuable days of surgery on a hit or miss procedure like megasession FUE, particularly when I know I could have scheduled sure-fire strip surgeries on those days.".

 

Additionally, there have also been many other threads on this forum and others that discuss this.

 

Therefore, I dispute your statement stated below.

 

--- by Hairroot ----

 

The success rate for FUE is ONLY lower if performed but an incompetent Dr who forces FUE unlike Dr Feller who performs it correctly with the appropriate size tools.

 

 

 

Everything else you are saying, I agree with (except your pointless attacks on me) But again, I did not question Dr. Feller's generosity or integrity or his ability as a surgeon.

 

Now attempt to take the other side for a minute...you are now a patient who just signed up for FUE megasession and you knew all the risks because Dr. Feller informed you of them. Dr. Feller has clearly admitted that it's possible for the surgery to be a failure after 40 minutes or so, so you have to admit, the possibility IS THERE. So if you were on the side of the failure here, do you still not see the points that I'm making? I encourage you to "put down your guard" and re-read my post WITHOUT defenses up, and read them as one who is playing devil's advocate to try to protect patients.

 

Do you honestly think that I do not care about all the patients who were butchered? If I care about this particular post, of course, how much more do I care about them? Why do you think I'm still here? I'm here to receive support from fellow members in my journey yes, but also to support and help others make EDUCATED decisions to AVOID those situations. But honestly, your statement here was an obvious attempt to make me look like I'm trying to slander a good doctor and deviate my attention from the point. Your attempt has been denied.

 

I have declared many times how Dr. Feller has done excellent work (not only on this thread, but others), even directing patients to him even though I have no personal ties to him. Can you say you do the same without bias? I am not trying to toot my own horn here...I am far from perfect and have my problems....but if I was here with a negative motive, I think people would have figured that out by now .

 

One more point...I never stated that he should give FUE for free to non-candidates. What Dr. Feller stated was, he will only do the surgery on people who are potential candidates (which IS ethical and good), but that there is a chance that once they come in, it won't work, since there is no way to really determine for 100% if they are true candidates or not until AFTER he starts the surgery. What I stated was...In this situation, I believe (personal opinion), that IF the patient can't do strip or is strongly against it, that 1) he give the patient his money back (since these cases are far and few between, it won't happen very often) or 2) ask ahead of time that if the FUE megasession isn't going to work, if the patient is willing to go for strip...if the patient says YES, then Dr. Feller books the FUE megasession...but if the patient says no, then Dr. Feller not even attempt the FUE megasession as to not waste anyone's time, including the doctors.

 

Anyway...I think Dr. Feller is his previous post to me has SEEN that my post was not personal nor questioning his ethics...and I hope that he continues to see that and that you also see it.

 

Bill

 

P.S. Here I am like Billro/Velcro like it or hate it (Good one Nervous )

[Bill - Seemiller]

FUT by the methods utilized by the top surgeons allows approxiamately 98% graft survival. On the other hand FUE by methods available today by top docs allows only slightly over 90% graft survival which can be due to the damage of transcetting the follicles to the avulsion of vital elements of the graft. It is entirely due to the fact that in strip surgery, graft are transected under a high powered microscope while in FUE they are not.

 

Agreed!

 

Bill

[Bill - Seemiller]

Hairroot,

 

Btw...welcome to the forums . As B Spot said...we DO benefit from your posts as well and I'm grateful that you are sharing your experiences with us.

 

Bill

[no hair sux]

what factors make a patient unsuitable for FUE and what numbers constitute a mega-session?

[hairroot]

Billos, you stated:

 

"since the success rate is still much lower than strip, those patients that undergo FUE should be aware of this"

 

So am i right in thinking that we are debating approximately about 3-5% difference in yield when performed by a competent Dr like Feller?

 

 

 

FUT by the methods utilized by the top surgeons allows approxiamately 98% graft survival. On the other hand FUE by methods available today by top docs allows only slightly over 90% graft survival which can be due to the damage of transcetting the follicles to the avulsion of vital elements of the graft. It is entirely due to the fact that in strip surgery, graft are transected under a high powered microscope while in FUE they are not.

 

I am obviously not as knowledgable as you are. Strip yields APPROXIMATELY 98%, lets call it 95% and FUE over 90%.So we are talking 5% give or take.

 

Thanks for correcting me!

[Guest Cousin_It]

no hair sux...

 

In response to your question concerning if one is considered a good candidate for FUE, the test of choice is the FOX test. This is employed with a grading scale to determine the feasability of a particular persons ability to provide adequate follicles through FUE.

 

In this test several FUE extractions are initially performed. Further these are examined under microscope and graded on a scale of 1-5 based on if the entire shaft was extracted or if hair fragments were produced. Those that score consistently a 1 or 2 are deemed good candidates, 3 is marginal and 4 or 5 are unacceptable.

 

As far a what is considered a megasession, rule of thumb would be over 1000 grafts. So far I believe the highest FUE megasession has been roughly 2000 grafts. Hope this answers your question.

[Guest Cousin_It]

hairroot...

 

The 90% is the case in only the most competant hands, most doctors not so gifted would be hard pressed to even produce 75%. On the other hand the 98% is common practice nowadays by most. So in essence the difference can be more substantial than stated.

[no hair sux]

thanks, cousin. i've heard of the fox test before but had no idea what it was.

 

these megasessions, are they considered so because they're taken all in one day? i always thought fue procedures were spread out over several days(i.e., 500 grafts per day).

 

i need probably 2000 - 2500 grafts, but i don't want a strip scar. i hoped fue would do the trick, but i'm not so sure anymore.

[Dr. Alan Feller]

Bill and B spot,

 

I don't take this thread personally at all, so no problem. I enjoy this banter when I get the time to participate.

 

I find it interesting that you two view the patient as the "little guy" and the doctor as the "big guy".

 

I think this view goes way beyond an HT discussion, but in short if falsely casts the doctor as the "oppressor" and the poor patient in the role of "victim". (Bill I know you don't mean it literally so don't take it to heart)

 

It completely ignores that a MUTUALLY beneficial agreement was struck by two EQUAL individuals PRIOR to execution of the deal that had the benefit of FULL disclosure along with extensive due diligence and informed consent.

 

Both parties are EQUAL, don't you see that? There is no "big guy" little guy". It doesn't matter if it's a doctor/patient, company owner/client, or cab-driver/fare, pretzel vendor/Donald Trump or Donald Trump/ Bank president.

 

Example:

Who is the "big guy" in this relationship:

 

Donald Trump/ His new wife's divorce attorney ?

 

There is really only a couple of ways a person can become the "big guy" and that's by FORCE or DECEPTION. In any other situation the so called "little guy" can just walk away. Isn't that obvious???

 

NervousNelly,

I don't think being honest about my profit motives should concern you. I don't think being candid and open about it should be seen as "harsh". Don't you work for a living and hope and expect to earn as much as you feel your efforts are worth? Of course you do, it's human nature. It's only when Force or Deception is used to stifle that human drive that society runs into problems. Look at communist Russia or Socialist Western Europe. Vilifying or shunning profit has ALWAYS proved to be catastrophic and creates the largest number of truly oppressed "little guys" that you can imagine.

 

Everything around you was created and manufactured solely and exclusively by people who had profit motives in mind. That is THE driving force of every slave-free economy since the dawn of mankind. Profit is not a pejorative term and it shouldn't be whispered. I won't.

 

At the same time I don't worship at the "alter of the dollar". I know some that do and they truly disgust me. They give nothing away and account for every penny in their lives like it were their last, an exhaustive and (ironically) costly obsession.

Sorry for the lecture, but this thread was screaming out for it. Again, I don't take anything here personally. I never thought my reputation was impugned, nor do I feel I have been "torpedoed".

 

My basic philosophy is that if you remain optimistic, driven, hard working, and above all HONEST with your fellow man, prosperity sneaks up on you. Doesn't matter what your occupation or station in life is, success is an equal opportunity stalker.

 

Dr. Feller

[NervousNelly]

Dr. Feller,

 

This has been an interesting thread. Ofcourse as we all know in any forum like this we type what we want and wait for a response. Quite often what we say is misinterpreted or we don't get that immediate opportunity to elaborate or qualify our statements.

It is very clear that none of us questioned your skills or ethics as a doctor and you have acknowledged that as I am glad to see. We do appreciate you engaging in a little banter with us about several different topics--just this time it pertained to your office policies. I'm pretty sure that you understood that I was in your corner backing your policy because it makes sound business sense. I guess I just thought that it might have been best to be a tad bit more toned done when discussing your desire for profits. This is not a bad thing though as you are displaying your honest thoughts and I shouldn't fault you for that. You asked me about my aspirations in my professional life for wanting to achieve as much as I deserve and you are right. The difference is that I try to not display that in front of potential clients. Just a difference between us and neither are right or wrong.

 

I appreciate your response, your honesty and your skills as a physician. You have provided a lot for this forum and this field in general. I respect you and your philosophies and I hope that you continue to be a strong supporter of this site.

[Bill - Seemiller]

Great post Dr. Feller and thanks for participating. I'm glad you saw my message for what it was and didn't take it as an attack on your integrity.

 

Yes, surely one can debate what defines "big guy" and what defines "little guy". Surely there is no way to determine whether the doctor or patient is more wealthy than the other, but I suppose I define "big guy" in this case as the person in power in the relationship. The doctor is clearly in the drivers seat and calls all the shots. The doctor of course gives some power back to the patient by asking what he/she wants, but once that patient goes under the knife, it's all about trusting that the doctor (in the driver's seat) will do the best job possible for their benefit. Now, of course, I'm not questioning that you do the best job possible to benefit the patient...as I know you do...heck, I've seen what you can do, at least in pictures. BUT, clearly, you are the person in power, and you call all the shots, including the fees collected. Let's be honest...most "little guys" or the person without power in the relationship aka, the patients, are making a BIG investment when they go in for an HT. I know I had to juggle around a lot of funds to afford all the surgery I had. I'm simply stating that for most patients, $4000 is a LOT of money to pay for something IF it ends up being unsuccessful.

 

Surely I agree with what you are saying "...struck by two EQUAL individuals (and the key word here) PRIOR (end key word) to execution of the deal..." Once the deal is struck, however, the patient is now without power, only the doctor has the power, hence becoming the "big guy". Let's look at it closer...who is the one who can effectively change the agreement after the deal has been made? Only the doctor right? If the patient said after you attempted FUE and it failed for whatever reason, "well, I changed my mind, I want all my money back", you could simply say "no, we had an agreement" and in all technicality, the patient would be FORCED (there's your definition coming out on how the "big guy" is played out) to pay up. On the flip side...if you attempted FUE on the patient, and it failed, and the patient was about to hand you the $4000 and you said, "I changed my mind...you can keep your money", the patient (wouldn't first of all, for obvious reasons) couldn't say, "hey, we had a deal, you HAVE to take the money". The very thought of that is indeed obsurd to begin with, but it still holds true, regardless of the fact that it's obviously in the patients favor on my latter example.

 

So really...I agree that since you are up front ahead of time with the patient and they KNOW what they are getting themselves into, that you are doing everything ethically correct. However, since it's POSSIBLE that the patient could be jumping into an agreement based on a heart decision (with the hope of getting more hair), in the event it fails, you may eventually run into one angry patient who will attempt to slander your name. My hopes is that this never happens, as is obviously yours.

 

Now for me...I don't make that many heart based decisions only about anything...I've become far to skeptical about anything and feel that research and thought is always important and required in every decision. Therefore, IF I was a perspective candidate for FUE megasession because I desperately wanted to avoid a scar, I would most likely opt NOT to go with FUE with you, because I don't want to risk losing $4000. It's simply a lot of money to lose for a "little guy" like me.

 

That all being said...my personal opinion is and remains, that since FUE megaession failures are far and few between, especially since you have pioneered the technique to a higher success rate, that in the rare even that it DOES occur, let the patient who is spending his life savings on the hopes of getting some hair back have his money back in the event that he is not a candidate for strip surgery or truly is adamantly against strip.

 

If I do not persuade you, that is of course, fine...what you are doing is fair and ethical...just keep in mind that patients agreeing to your terms MAY be making heart decisions and not truly appreciate and understand the risks, even though you spell it out to them over and over again. It will be important to see through the patients that are placating you simply to get you to do surgery on them, because they are pretty much assuming "a failure won't/can't happen to me", only to become extremely distraught and angry, questioning your talent and ability in the event things don't go their way. (shew...insert big inhale here)

 

Feel free to continue debating with me...I enjoy a good jousting and don't take it personal. I'm glad you don't either. I still hold your practice and work in the highest regard and appreciate your participation on this forum.

 

Bill

 

The patient now has to live with his/her decision with the HOPES that it will be successful and live with the possibly devastating disappointment if it fails, maybe even possibly cursing your name for making a faulty deal (not saying it is...but in the perspective of a failed patient who blew $4000 on nothing, anger can get the best of him/her).

[Bill - Seemiller]

Billos, you stated:

 

"since the success rate is still much lower than strip, those patients that undergo FUE should be aware of this"

 

So am i right in thinking that we are debating approximately about 3-5% difference in yield when performed by a competent Dr like Feller?

 

 

 

quote:

FUT by the methods utilized by the top surgeons allows approxiamately 98% graft survival. On the other hand FUE by methods available today by top docs allows only slightly over 90% graft survival which can be due to the damage of transcetting the follicles to the avulsion of vital elements of the graft. It is entirely due to the fact that in strip surgery, graft are transected under a high powered microscope while in FUE they are not.

 

 

I am obviously not as knowledgable as you are. Strip yields APPROXIMATELY 98%, lets call it 95% and FUE over 90%.So we are talking 5% give or take.

 

Thanks for correcting me!

 

Hairroot, yes, you are correct, if we are indeed talking about just the success rate of strip, in the hands of a skilled physician, the percentage is not that far apart...so perhaps I should take back the part of my sentence that says "MUCH lower", but it is indeed lower, and as Cousin_It pointed out, the percentage of yield can go down in the hands of less qualified surgeons.

 

However, when looking at FUE as a whole, I also stated that it's inferior to FUT, and I meant it for many reasons. I'll list them here:

 

1. FUE has a lower growth yield (as discussed above)

2. A megasession of FUE is far inferior to that of strip. 1000 grafts max out of FUE hardly compares to 5000+ for strip.

3 Cost, though secondary to the other points, is a factor contributing to it's inferiority, just about twice the price per graft as Strip.

4. There are fewer candidates for FUE than there are for strip.

 

And as a side point, though your head shows an impeccable donor area, this is not always the case and scarring is still possible. Keep in mind I've seen some pretty impressive trichophytic strip scars as well, where when shaved down to a 1 clip, you still can't see the scar. BUT, this also, like FUE is not an exact science and possible that the scar won't be perfect every time.

 

So...though I may have overstated the lesser success yield of FUE, FUE is still inferior for most patient with a severe balding scalp because the sheer number of grafts they will need is more sufficiently achived with strip.

 

This, however, is not to knock in any way the ability of Dr. Feller nor FUE as a practice. It just seems to me that FUE has a long way to go before it can really compete with strip. Now for patients like you with minimal loss who used FUE to redevelop a nice hairline, since you had no loss in the crown or mid section, FUE was apparently a perfect solution for you. And I'm happy for you. But it's just not feasible for everyone.

 

And now I have writer's cramp . Have a good night.

 

Bill

[John_in_NC]

as someone who has had FUE with Dr. Feller: (I will only comment on the procedural stuff since I'll wait a few more months for the rest)

 

He is EXTREMELY honest when it comes to the risks of scarring (internally) and the $4000 payment if your head is not ideal for FUE. He mentions the risks so many times I wanted to press fast-forward , but he wants to make sure that you realize what you're getting into. I knew all the risks, and was willing to go home with a few red dots, no grafts and $4000 poorer. I figured out that worst case scenarion, I'd have to wait a few years till the technology got better.

 

He is there, tells you all the pros, cons, possibilities, costs and risks involved and YOU as an adult make the choice. You do not have to have FUE, or an HT for that matter. Plus, there is no gun to your head while you decide.

 

As long as costs are out in the open, all we should worry about is quality of the HT, the rest depends on each person. $4000 for us may seem a lot but we spend that much probably on beer and gadgets a year. I was willing to take a chance and it worked out great. I have my back hair at a #1 and I am NOT conscious of it at all; no one will see anything. Maybe if an HT doctor stands a feet away he might notice something, but who cares. The odds of that happening are 1 in a billion.

[no hair sux]

fue may have a lower yield(still not sure about that), but cutting a huge chunk of my scalp out scares the living sh!t out of me

[hairroot]

Merry xams

Hairroot

[the B spot]

Dr. Feller----- I am not pointing to you as the big guy lording over the little guy in this situation.

 

I just merely stated that I am all for the little guy winning.

 

After reading some of your exchanges, should you find yourself in Chicago or I end up in NY for some reason, I would like to buy you a beer or 3!!!!!

 

Anyway, Merry Christmas to all, and I am glad that everyone can come away feeling good for contributing here.

 

much love...............

[Bill - Seemiller]

Spex,

 

You have a good point brother, comparing it that way, there is less of a difference...to me, it's difficult to compare apples to apples, however, since I'm comparing the capabilities of both at it's best, rather than 1000 vs 1000. Comparing it that way, you are correct...the growth yields are similar (95-98% for strip) verses (90% for FUE). And yes, I believe that Dr. Feller is very capable of high yields in FUE. In fact, IF I ever considered FUE, I would be going to see Dr. Feller. Of course, I'd have to think long and hard about the possible loss of $4000, since I'd only go for FUE at this point IF I feel I needed more density and IF I was told that I have no more donor for strip surgeries.

 

John_In_NC,

 

Glad to hear that Dr. Feller was up front with you...I figured he would be. Regarding the rest of what you said...I agree that the patient makes an adult choice, I just feel that there are better choices that the doctor could offer. Since I spelled that out in my previous posts when sharing my opinion, I won't repeat it all here again.

 

To Everyone,

 

I'll further add that it was because of Hairroots post and Dr. Feller's explanations of FUE on this and other forums that has made me take a serious look at FUE (not necessarily for me, but in general). FUE has come a long way in the last year which is very exciting.

 

Thank you to all that posted and Merry Christmas to everyone!

 

Bill

[Dr. Alan Feller]

Bill,

I don't think you are getting the point. I am not the one in power in this scenerio. I am admitting just the opposite. It is the patient's physiology that is in control, not me.

 

I am charging to ATTEMPT to do the surgery. The price is a mixture of the skill and experience I've accumulated over the years in FUE as well as the amount of money I would have made if I had signed a strip patient up for that very same day.

 

Market forces and simple economics determine my price in order to stay competative and viable. I don't have any choice in the matter.

 

Unfortunately, many people just FEEL it's wrong for physicians to make money off of people's misfortune and support socialized healthcare systems that strip the profit out of medicine. All this does is decrease the quality of healthcare, and if (when) that happens in the U.S., that will be end of high quality medicine and research and development.

 

I'm not saying YOU want to socialize medicine, but your arguments are at the very core of those who do. Think about it.

[Bill - Seemiller]

Dr. Feller,

 

Bill,

I don't think you are getting the point. I am not the one in power in this scenerio. I am admitting just the opposite. It is the patient's physiology that is in control, not me.

 

 

You are clearly not talking about the same thing as me regarding power, therefore it is you who are not getting the point. Re-read how I defined power and my examples...I was talking about decision making, not the success or failure of the surgery. You are talking about power to perform the surgery...whereas I agree that the patients physiology is in control. I'm talking power in decision making...I made that clear above I thought. YOU are clearly in power and make the rules. Your rule that was made in power: "I will attempt the surgery, but if it fails, I will collect $4000". If the patient agrees, only one has the power to change the original agreement...the doctor. YOU are able to decide in the event of a failure to give the patient his money back, the patient is not allowed to decide that he won't pay up. Clearly you must see this.

 

I am charging to ATTEMPT to do the surgery. The price is a mixture of the skill and experience I've accumulated over the years in FUE as well as the amount of money I would have made if I had signed a strip patient up for that very same day.

 

 

That's the point I'm making...I personally feel that you should charge for the surgery, not for an attempt at surgery. Maybe the answer is trying to determine better ways (if possible) to determine before starting the surgery as to whether or not FUE will be successful. Since Strip is a "sure-fire" thing, perhaps there are ways to determine whether or not FUE will be a sure-fire thing before starting, but you or nobody else knows what it is yet. Perhaps the answer is more research! To be clear: I don't question the price of what you are charging, only the fact that you charge even if it's a failure (due to situations beyond anyone's control). Do you charge for consultations or do you offer them free? Does that not take up a lot of time that you could be spending in surgery? Maybe you do your consultations at night which doesn't interfere with your surgery days? Perhaps FUE megasession patients should be handled like that too, that way it won't interfere with a day's work, and then you get EXTRA money if it's a success, and if it's a failure (which apparently is rare), the patient doesn't lose money and you don't lose a normal day of surgery.

 

Market forces and simple economics determine my price in order to stay competative and viable. I don't have any choice in the matter.

 

With all due respect, economic laws are man made, not laws of science that can't be changed. Everyone has a choice, and it is those choices that effect economic laws yet everyone acts like economic laws affect their choices. In the question of "what came first, choices or economic laws", the answer is clearly "choices".

 

 

Unfortunately, many people just FEEL it's wrong for physicians to make money off of people's misfortune...

 

 

 

There are multiple arguments that can be made for both sides, a socialized health care system and a capitalistic one. I admit that I'm a bit I'm not a big fan of either in entirety, and here are the quick summations of why:

 

1. Capitalism: survival of the fittest - some people who may have never had a chance in other nations may do well off, however, the weak die off and nobody wants to give them a break - can encourage selfish living

2. Socialism: Is ideal but will never work. Quality of goods will diminish significantly. The reason: very sad...lack of motivation since there would be no personal gain (defined as selfishness). Nobody really wants to help anyone else without benefiting from it in some way themselves (whether monetary or other)

 

I'm sure somebody will want to tear the above apart, but the bottom line is even at a person's best, nobody is perfect (I think we can all admit that), and more times than not, people are out for themselves above all else. Look at traffic as an example...people are always swearing at each other, cursing, and angry (tell me that you don't get angry in traffic and I'll call you a liar)...why? All because other people have the NERVE to be in OUR way! Our personal driving goals have been blocked by other people, so we are angry, and we get angry because we are selfish. I am not immuned to this either...I am not preaching anything I can't relate to...so I am not saying that I am above all this...I am guilty as well. The problem is with humanity in general and can't be solved with any logical reasoning. Therefore whether capitalist, socialist, or any other philosophy, none of it is perfect because people aren't perfect.

 

Since it's the Christmas season, I'll say this (whether anyone feels this is inappropriate or not, it's what I believe): How amazing is the love of Jesus Christ, who came into the world to die for us imperfect people, people that were once God's enemies as sinner, but now can be called Sons of God because of Jesus' sacrifice for us, for those who believe and put their faith in Him.

 

Now THAT is love, THAT is sacrifice, and THAT is selfLESSness rather than selfishness. And the only way we will have a heart to be selfless like this is through Jesus Christ. But otherwise, we have to simply accept what is and make the best decisions we can based on what we are offered....and as people, WHEN we have power, to try to do what's best to help all parties.

 

All that to say, however, I don't think it's accurate or a fair evaluation for you to say that my views are socialist just because I don't want to see a patient lose money over a failed surgery (even if the patients physiology is the problem). I don't question your prices and I certainly don't question your profit. But I don't think it's out of the patient's best interest to collect money for a failed surgery. Just my opinion.

 

Anyway...enough ranting for me. I'm off to get some Christmas Eve dinner! Merry Christmas to you Dr. Feller (and everyone else reading this).

 

Bill

[Riggs]

Originally posted by Bill:

Dr. Feller (and all),

 

Great posts from all of you. Indeed I shared my honest thoughts about this to generate discussion on the topic, so I'm glad that it did just that and that nobody took it personally.

 

I want to make clear that I don't have any ethical issue here with what Dr. Feller is doing. Dr. Feller is clearly stating to his patients what he intends, and his patients either agree or disagree to the terms. I do, however, have a personal problem with it...as I'll define further below by addressing some of the points Dr. Feller has made. These are just my opinions, and anyone can take them or leave them.

 

Just to hit a few of Dr. Feller's points and reply to them

 

1. FUE procedures are no longer experimental. They are now a proven entity and have entered the mainstream of modern hair transplantation. Body hair FUE has NOT. The two are not comparable.

 

Yes, I am aware that they are not experimental like BHT (sorry if I used that word by mistake), so perhaps comparing the two isn't completely fair, however, since the success rate is still much lower than strip, those patients that undergo FUE should be aware of this (which seemingly, you present to them in some way, hopefully in writing), so there is no problem there.

 

3. What I have learned from practicing FUE from 2002 to now is that NOT everybody is a candidate, and even fewer are candidates for FUE megasessions. Any doctor claiming that they can do FUE on everybody is doing one of two things: a. They are lying about the actual number of grafts they report

or

b. They are switching up to larger punches beyond .9mm in diameter which takes the procedure out of the FUE realm and into the old "plug" territory.

 

Since I refuse to do either of the above, I would rather tell the patient before

hand that they simply may not get the number of grafts desired.

.

 

I think this is good...I am aware that not everyone is a candidate for FUE, and it takes an ethical doctor to refuse surgery on someone who is not an FUE candidate...so this is good. I've read about too many doctors doing surgeries on patients that are not candidates and it turns out to be a nightmare. Regarding ethics, I do not question you.

 

4. I want to make it clear that I am an unabashed and unapologetic capitalist. I absolutely love performing surgery , but I am also in business to make money and I, like you, strive to work in the most efficient manner toward that end. This hardly means that money is "everything" to me. On the contrary, I have been donating my services for years and have a waiting list for my pro bono patients well into 2007. But I can't afford to lose valuable days of surgery on a hit or miss procedure like megasession FUE, particularly when I know I could have scheduled sure-fire strip surgeries on those days. Yes, it IS about the money as such days like those can add up.

 

This is more of a personal problem with me rather than an ethical one. I simply suspect that patients (even though they know the facts) can be exploited, even if unintentionally (which I truly believe Dr. Feller, that you would not do it intentionally). There are certain states that people can be in which "clouds" their ability to make an informed decision, typically those states are normally those in desperation. There were big controversies way back when whether it was ethical to perform medical experiments on prisonors even though they agreed, because their "state of mind" was said to be clouded. Inevitably, medical experiments were mandated to be stopped on prisoners. Though it's not a perfect comparison by any means, someone going into get an HT by a well known doctor who constantly yields excellent results could be "clouded" with excitement with hopes and dreams of a new head of hair and agree to anything just so you'll perform the surgery on him. So in the event of a failure of the FUE surgery, this patient COULD argue that he let his excitement cloud his judgement and get the best of him. Now I'm not stating that this is your problem Dr. Feller, at least, not entirely...a patient MUST own up to their own decision making...however, I just see this as a potential issue, that could arise and come back to bite you.

 

And as one who is not a strong advocate for unabashed capitalism (simply because it's easy for the little guy to get stepped on), I'd like to see the PATIENT win out rather than the DOCTOR in the event of a failure. This is a personal opinion. I agree that you are doing everything to inform the patient of the situation, and if he agrees, it's on his head...however, it's the philosophy I have a problem with. The bigger guy can afford the loss...the little guy can't. So I think the bigger guy should let the little guy win in the event of the failure.

 

5. While I may not be able to perform a megasession FUE on a particular patient, it doesn't mean they have thrown away $4,000. They always have the option to switch it to a strip procedure on that very day and apply every dollar of the $4,000 to the strip. In this scenario I make no money for attempting the FUE megasession.

 

In most cases yes...but think about those people who want FUE:

 

1. They are trying to avoid a strip scar

2. They might be like me and wanting to tap into reserves when they are stripped out

3. Want faster healing time

 

Since you've only ran into this situation one or two times (which is good), we don't really know if it happens again which patient might be the bombshell who will set off based on my above points. Again...I rather see the little guy win over the bigger guy, if things don't work in the little guys favor.

 

I do all of this not because I want to make money for doing little or nothing, but because I want to see the best results possible.

 

 

I know you care about your patients and want the best possible result for them...but:

 

1. "unabashed and unapologetic capitalist"

2. "can't afford to lose valuable days of surgery on a HIT OR MISS procedure like megasession FUE, particularly when I know I could have scheduled sure-fire strip surgeries on those days"

3. "Yes it IS about the money as such days like those can add up".

 

I'll add a few more opinions here.

 

1. If the surgery is HIT or MISS...why do you offer it when you know very well the patient MIGHT come out disappointed and lose $4000? He might not opt for strip or even have the option for it.

 

2. When you say you "can't afford it", I'm assuming this is the capitalist side of you that wants to make the most money possible talking. Surely you CAN afford it since the percentages of this happening are obviously extremely small, as you said one or two. But I think most likely who CAN'T afford it is the patient who might be stuck shelling out $4000 and get nothing in return IF they can't opt for strip or choose not to.

 

3. I know you love your work...and you do it well. I also know that as a business, it's important to make money, and I don't question your desire to make money...after all...that's the main reason why we work isn't it? If I could...I'd retire and I'm only 29

 

My entire post can be summed up in this statement: It's good to make money, it's great that you love your work, but I think sometimes it's better to give the little guy the victory when in doubt. In business, sometimes it's better to cut your losses in order to keep the customer (or patient in this case) happy. Heck, after all, the patient is already going to be disappointed enough that FUE won't work for him...let him have his money back and take it as a loss. Surely...any doctor in your fiend CAN afford it with a heavy clientele like yourself. In the longrun, I think you'd be even MORE respected if a failure like this does come up, and you give the patient his money back IF he strongly objects to strip.

 

Anyway...on a brighter note...I think you do great work and I still believe that you have taken FUE a long way. I'll be interested to see when and if this will evolve even further in the coming years.

 

Bill

[Riggs]

Bill

 

Your points are EXCELLENT! You outlined everything to perfection and truely appreciate your analytical thought process. Dr Feller, from what I have heard is an excellent DR, but you truely made him answer for all the comments he made and some comments he made I bet he wished he could retract. Sometimes even when the most polished professionals talk / write (dr Feller) they do not grasp some of the comments they are making. Then when a person like yourself can go back and disect what they said and show true discrepencies in their statements that person comes across with other alterior motives (ie the money discusion and time)

[Bill - Seemiller]

Thanks for the comments Riggs. Just for the record, however, I still stand by the fact that Dr. Feller is a superb doctor and by no means have any hard feelings against him. He is entitled to his view as I'm entitled to mine. But part of our mission here is to challenge what needs to be challenged. In the longrun, the goal is to make everyone smarter . Thanks again for the encouragement.

 

Bill

[Hairfree]

Hey Bill-

 

I just came across this posting from Christmas eve. Very impressive posting and you make a very sound and reasonable argument in Dr. Feller's response. I agree with you on the principles of how patients should be treated.

 

Now you may not enter my home again because you are a socialist haha I am just kidding. I hold the same views as you. There is not one single perfect system for society. Everyone individual will have a viable argument in this case. You hit the head on nail. We are not perfect beings. Although, I take pride in my patience when driving, but I do have many other weaknesses when it comes to patience.

 

I fully understand that the patients comes first. They are the ones paying and come to YOU for surgery. We don't go shopping to buy a worn out rug at Kmart. When we open the box and find that the rug is thin and worn out we take it back and get our refund or a new one! On top of all this, it's the reputation of the surgeon thats more important especially in this new technology age. Everything is information orientated. We can find out if something it good or bad by just a push of a button. Scary but good for those who do the homework.

[Bill - Seemiller]

Haifree,

 

Thanks for the comments man. Yep, I posted this awhile ago...almost forgot about the post...well, not entirely...I've referenced it a few times when talking about FUE.

 

Now you may not enter my home again because you are a socialist haha I am just kidding

 

 

LOL...yeah well...Jesus was a socialist...to some degree...not entirely...in a perfect utopian world, it would work...but not here

 

Happy Easter everyone!

 

Bill